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Phase 2 Study of Lovastatin as Breast Cancer Chemoprevention

This study has been terminated.
(Slow accrual)
Sponsor:
Information provided by (Responsible Party):
James Ford, Stanford University
ClinicalTrials.gov Identifier:
NCT00285857
First received: January 31, 2006
Last updated: January 19, 2017
Last verified: January 2017
  Purpose
The study evaluates if a 6-month course of oral lovastatin at 80 mg/day would decrease abnormal breast duct cytology in women with a high inherited breast cancer risk.

Condition Intervention Phase
Breast Cancer Drug: Lovastatin Phase 2

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 2 Trial of Lovastatin for Modification of Abnormal Breast Duct Cytology and Risk-Associated Biomarkers in Women at High Inherited Risk of Breast Cancer

Resource links provided by NLM:


Further study details as provided by James Ford, Stanford University:

Primary Outcome Measures:
  • Change in the Incidence of Abnormal Breast Duct Cytology After Treatment With Lovastatin 80 mg/Day [ Time Frame: 6 months ]

    Assessed on that basis of pre- and post-treatment evaluation with RPFNA (random periareolar fine needle aspiration). All subjects received a prescription for lovastatin 80 mg/day, to be taken as 40 mg twice-a-day.

    Cytology was qualitatively and quantitatively, using the Masood semiquantitative scale to assign a number to each specimen, with higher numbers indicating increasing degrees of abnormality, as follows:

    06-10 Non-proliferative breast disease (NPBD)

    11-14 Proliferative breast disease without atypia (PBD-A)

    15-18 Proliferative breast disease with atypia (PBD+A)

    19-24 Carcinoma in situ and invasive cancer (CIS/IC)

    If no cells could be obtained after multiple RPFNA attempts, the classification was acellular.

    Change from NPBD to PBD-A was considered Unfavorable.

    Change from NPBD to Acellular was considered Equivocal.

    Change from PBD-A to NPBD was considered Favorable.



Secondary Outcome Measures:
  • Change in Mammographic Density Before and After Treatment With Lovastatin 80 mg/Day [ Time Frame: 6 months ]

    Bilateral mammography was performed at study entry (before lovastatin therapy) and at study conclusion (after lovastatin therapy) . Mammograms were assessed for a decline in mean breast density, using the American College of Radiology Breast Imaging Reporting and Data System (BI-RAD) composition system for mammographic density assessment.

    Category 0 Need additional imaging evaluation

    1. Negative
    2. Benign
    3. Probably benign
    4. Suspicious abnormality
    5. Highly suggestive of malignancy
    6. Known biopsy-proven malignancy

  • Change in Total Cholesterol After Treatment With Lovastatin 80 mg/Day [ Time Frame: 6 months ]
  • Change in Low Density Lipoprotein (LDL) After Treatment With Lovastatin 80 mg/Day [ Time Frame: 6 months ]

Enrollment: 30
Study Start Date: November 2005
Study Completion Date: December 2010
Primary Completion Date: May 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Lovastatin 80 mg/day
Lovastatin 80 mg/day as 40 mg orally twice daily, for 6 months.
Drug: Lovastatin

Lovastatin 80 mg/day as 40 mg orally twice daily.

Lovastatin is approved by FDA as a cholesterol-lowering agent.

Other Names:
  • Mevacor
  • Advicor (as a combination with niacin)
  • Altocor
  • Altoprev
  • Statosan (Atos Pharma)

Detailed Description:

The study evaluates if a 6-month course of oral lovastatin at 80 mg/day (as 40 mg twice-a-day) would decrease abnormal breast duct cytology in women with a high inherited breast cancer risk. Breast duct cytology was assessed as hyperplasia or hyperplasia with atypia, as measured by random periareolar fine needle aspiration (rpFNA), of breast duct cells.

A stratified analysis of this objective will be performed according to BRCA mutation status (absence or presence of an inherited deleterious BRCA1 or BRCA2 mutation).

Additional objectives of the study are to:

  • Assess change in mammographic density, which is known to associate with breast cancer risk, before and after treatment with lovastatin
  • Asess incidence of breast cancers and new high-risk breast lesions, including atypical hyperplasia, ductal or lobular carcinoma in situ, or radial scar.
  • Assess change in other breast cancer risk-associated biomarkers in rpFNA specimens, including:

    • Ki-67 (a marker of cell proliferation)
    • Estrogen receptor (ER)
    • Progesterone receptor (PR)
    • HER/2-neu over-expression
    • Susceptibility to DNA damage
  Eligibility

Ages Eligible for Study:   18 Years to 65 Years   (Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

INCLUSION CRITERIA

  • Female
  • Increased inherited risk of breast cancer, as defined by:

    • Known deleterious mutation in BRCA1, BRCA2, or other high-risk mutation
    • Family history conveying at least a 2-fold increase in breast cancer risk
  • ECOG performance status 0
  • Normal organ and marrow function, including complete blood count and comprehensive metabolic panel within normal institutional limits
  • Subject agreement to limit alcoholic beverage consumption to three alcoholic drinks per week.

EXCLUSION CRITERIA

  • Prior history of invasive breast cancer less than 2 years previously (EXCEPTION: stage III or lower breast cancer > 2 years ago)
  • Current or history of other cancers (EXCEPTION: non-melanoma skin cancer, or stage III or cancer without evidence of recurrence for 5 years
  • Initial mammogram, breast MRI, or clinical breast examination prompts recommendation for biopsy by study investigators.
  • Evidence of malignant cytology on initial rpFNA.
  • Use of other investigational agents.
  • Use of tamoxifen or selective estrogen response modifiers (SERMS), including raloxifene, within the last 2 years.
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to lovastatin.
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection; symptomatic congestive heart failure; unstable angina pectoris; cardiac arrhythmia; or psychiatric illness/social situations that would limit compliance with study requirements.
  • Currently receiving lovastatin and cyclosporine, gemfibrozil, erythromycin, fibrates or niacin, (unless discontinued for study participation)
  • No evidence of active liver disease, nor elevation of serum transaminases (prior history of liver disease, if not currently active, is not an exclusion)
  • No evidence of myopathy or myositis, including symptoms of generalized muscle aches or weakness, muscle tenderness, or elevation in creatine phosphokinase.
  • Lactating (breastfeeding)
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00285857

Locations
United States, California
Stanford University Cancer Center
Stanford, California, United States, 94305
Sponsors and Collaborators
Stanford University
Investigators
Principal Investigator: James Ford, MD Stanford University
  More Information

Publications:
Responsible Party: James Ford, Associate Professor of Medicine, Stanford University
ClinicalTrials.gov Identifier: NCT00285857     History of Changes
Other Study ID Numbers: IRB-13732
BRSNSTU0010 ( Other Identifier: OnCore )
95505 ( Other Identifier: Stanford University Alternate IRB Approval Number )
Study First Received: January 31, 2006
Results First Received: November 17, 2016
Last Updated: January 19, 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Keywords provided by James Ford, Stanford University:
duct cytology

Additional relevant MeSH terms:
Breast Neoplasms
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases
Lovastatin
L 647318
Dihydromevinolin
Anticholesteremic Agents
Hypolipidemic Agents
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Lipid Regulating Agents
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Enzyme Inhibitors

ClinicalTrials.gov processed this record on August 21, 2017